The Final Four consisted of Kansas, making their second straight appearance, Marquette, making their first appearance since they won the national championship in 1977, Syracuse, making their first appearance since 1996, and Texas, making their first appearance since 1947. Texas was the only top seed to advance to the Final Four; the other three (Arizona, Kentucky, and Oklahoma) advanced as far as the Elite Eight but fell.

Syracuse won their first national championship in three tries under Jim Boeheim, defeating Kansas 81-78 in what would be Roy Williams' final game as head coach of the team; he would depart to become the head coach at North Carolina, a position he still holds as of the 2015–2016 season.

Freshman Carmelo Anthony scored 33 points leading the Syracuse Orangemen past the Texas Longhorns in the night cap of the National Semifinal doubleheader. Syracuse opened up a comfortable 2nd half lead, but that was trimmed to four with just 1:08 remaining. However, freshman Gerry McNamara iced the game with clutch foul shooting in the final minutes. The win put Syracuse and coach Jim Boeheim one win away from their first ever National Championship. Texas was the last number one seed remaining in the tournament.[1]

Leading up to the championship game, much of the conversation revolved around how, no matter the outcome, one of the well-known head coaches would win their first championship.[3] In Jim Boeheim's 27 years as head coach at Syracuse his team had been to two Final Fours, and finished runner-up each time (1987, 1996).[3] Roy Williams, during his fifteen seasons as Kansas head coach, had reached the Final Four four times, and finished runner up once (1991).[3] Syracuse dominated with a hot shooting first half to lead by 11 at the break. Gerry McNamara connected on an impressive six three-pointers in the half, which were his 18 points for the game. Kansas fought back to within 80-78 in the final minute and had a chance to tie after Hakim Warrick missed a pair of free throws in the final moments. Warrick, however, then blocked Michael Lee's three point attempt with 0.7 seconds remaining on the game clock. After Kirk Hinrich's three-pointer at the buzzer went over the net, Syracuse's victory gave them, and Jim Boeheim, their first ever national championship. Carmelo Anthony was named Most Outstanding Player (MOP) with 21 points in the win. Syracuse also avenged a second-round loss to Kansas two years earlier.[4]

Originally, CBS Sports was to have shown all 63 games of the tournament following the opening round, which was on ESPN. However, because of the start of the Iraq war the night before, the afternoon games on Thursday and Friday were moved to ESPN while retaining CBS graphics and production. CBS News then joined other broadcast and non-broadcast outlets in showing extended news coverage.

Thursday and Friday night's games were shown on CBS, albeit with frequent news updates. To make up for lost advertising revenue, an additional time slot was opened the following Sunday evening for more CBS telecasts.

2003 also marked the debut of Mega March Madness as an exclusive package on DirecTV. This offered additional game broadcasts not available to the viewer's home market during the first three rounds of the tournament. All games from the 4th round on were national telecasts.